Nontoxic Nodular Goiter

Definition

A goiter is an enlargement of the thyroid. The thyroid is a gland. It produces hormones that help regulate your body’s metabolism. It is located on the front of the neck, right below the Adam’s apple. Goiters are seldom painful. They tend to grow slowly.

There are different types of goiters. This sheet focuses on nontoxic (or sporadic) goiter. It is a type of simple goiter that may be:

Diffuse—enlarging the whole thyroid gland

Nodular—enlargement caused by nodules, or lumps, on the thyroid

The development of nodules marks a progression of the goiter. It should be evaluated by your doctor.

Causes

The exact causes of nontoxic goiter are not known. In general, goiters may be caused by too much or too little thyroid hormones. There is often normal thyroid function with a nontoxic goiter. Some possible causes of nontoxic goiter include:

Family history of goiters

Regular use of medications such as lithium, propylthiouracil, phenylbutazone, or
aminoglutethimide

Taking a lot of substances (goitrogens) that inhibit production of thyroid hormone—common goitrogens include foods such as cabbage, turnips, Brussel sprouts, seaweed, and millet

Iodine deficiency—though rare in the United States and other developed countries, it is a primary cause of goiter in other parts of the world, particularly in mountainous areas, or areas that experience heavy rainfall or flooding

Risk Factors

Nontoxic goiter is more common in women and in people over age 40.

The following factors increase your chance of developing nontoxic goiter:

Treatment

Nontoxic goiters usually grow very slowly. They may not cause any symptoms. In this case, they do not need treatment.

Treatment may be needed if the goiter grows rapidly, affects your neck, or obstructs your breathing.

If a nontoxic goiter progresses to the nodular stage, and the nodule is found to be cancerous, you will need treatment. Talk with your doctor about the best plan for you. Treatment options include the following:

Hormone Suppression Therapy

Thyroid hormone medication is used to suppress secretion of thyrotropin (TSH). TSH is the thyroid-stimulating hormone that causes growth. This therapy is most effective for early stage goiters that have grown due to impaired hormone production. It is less effective for goiters that have progressed to the nodular stage.

Radioactive Iodine

Radioactive iodine treatment is used to reduce the size of large goiter. It is used in the elderly when surgical treatment is not an option.

Surgery

Thyroidectomy is done to remove part or all of the thyroid gland. It is the treatment of choice if the goiter is so large that it makes it difficult to breathe or swallow.

Prevention

Be sure that your diet contains enough iodine.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.